Page 22

219126_NCS_Currents_March_2_eMag

FEATURED PROGRAM The University of New Mexico Neurocritical Care Program: People, Technologic Advances, and Scholarship By Isaac Tawil, MD and Howard Yonas, MD The University of New Mexico (UNM) centered care by pioneering the fi rst randomized trial of family School of Medicine and Health Science presence during the brain death evaluation (published in the Center takes much pride in their state-of- Critical Care Medicine journal in 2014). This trial could not have the-art 24-bed Neurosciences Intensive been accomplished without tremendous collaboration between Care Unit (NSICU). It is one of three adult NSICU providers at all levels. We hope this system will be ICUs at UNM and specializes in the care of adopted elsewhere to improve patient- and family-centered care. all neurosurgical patients as well as all patients Other strengths of our ICU include our adoption of technological with neurological disorders ranging from advances and the breadth of our faculty’s skill sets. We believe ischemic stroke to neuromuscular diseases. that, with the aid of both invasive and non-invasive monitoring, Isaac Tawil, MD UNM is a 450-bed hospital that serves as the we can best understand patients’ cerebral and systemic physiology. only level 1 trauma center and tertiary care Continuous evaluation of ICP, cerebral blood fl ow, brain tissue center for the state of New Mexico. It has been oxygenation, and EEG allows for assessment of a patient’s an accredited Advanced Primary Stroke Center autoregulatory status and enables individualized treatment. since 2008. Our current NSICU was the brain Beyond CNS monitoring, we use multimodality monitoring to child of Dr. Howard Yonas, Neurosurgery guide management of systemic organ function. Our clinicians are Department Chair, and in 2007 this vision increasingly using routine bedside echocardiography, continuous came to fruition with the move into the cardiac output, and functional hemodynamic parameters to new Barbara and Bill Richardson Pavilion at optimize treatment. UNM. The mission and care paradigm thrives A portable CT scanner allows us to minimize patient transport upon the key pillars of People, Technologic for imaging, enhancing patient safety. As a testament to Howard Yonas, Advances, and Scholarship . the advantages of our multidisciplinary backgrounds, our MD Our primary mission is caring for patients and faculty are profi cient at performing bedside tracheostomies and their families. The best culture and setting gastrostomies, further permitting a comprehensive approach to to do so comes from creating a “family” of caregivers. We start the care of our patients in the NSICU. In addition to our unit- with a multi-disciplinary group of attending physician intensivists based nurse educator, we have a dedicated nurse neurotechnology from various backgrounds including Neurosurgery, Emergency specialist responsible for education and troubleshooting of devices Medicine, and Neurology. A multi-disciplinary faculty facilitates a to assure safe use and appropriate interpretation of the various comprehensive exchange of perspectives and ideas that ultimately monitoring indices. benefi ts the patients and learners at all levels in our academic Lastly, we embrace our academic mission. We strive to environment. continually learn from our daily interactions with neurological This system can be seen on any given morning, where the patients in the NSICU and seek to improve the delivery of care, day begins with Imaging Rounds, a time in which the entire here and beyond. Dr. Yonas has built a research infrastructure Neurosurgery and Neurocritical Care faculty collectively review to study all aspects of neurologic diseases, from basic science diagnostic images on every patient. The multi-disciplinary culture research to bedside applications. We are privileged to participate continues on bedside rounds with engaged nurses, pharmacists, in large, multi-center studies in addition to smaller investigator- respiratory therapists, and nutrition specialists. All ancillary initiated endeavors. The group has published on a wide range of staff along with resident physicians from Neurosurgery, Neurology, neurocritical care topics. and Emergency Medicine contribute to the care of patients. Since we are in the “people” business, taking a family- centered approach is paramount and involves optimizing communication and transparency. A recent “ICU Whiteboard” initiative facilitates this communication by reviewing the daily care plan and provider contacts on a board at the patient’s bedside. Recently, we The research core group, from left to right: Rob Alunday, Mark Krasberg, Ed Nemoto, Amal Alchbli, Theresa enhanced family- Wussow, Sean Hagberg, Howard Yonas, Kim Olin, and Brittany Burlbaw 22 Continued on page 23


219126_NCS_Currents_March_2_eMag
To see the actual publication please follow the link above